Contact and Biographical Information:

Applicant's position in the lab(e.g., lab head, postdoc, graduate student):

Screen Number (if none, please enter "non-screening user"):

1. Detailed description of work to be performed. If this is not part of an ICCB-Longwood screen, please describe the overall project.(e.g., I need to maintain Vero cell cultures, fill 384-well plates with cell suspension, transfect cells with siRNAs, infect cells with virus-like particles derived from vesicular stomatitis virus, and fix cells for automated microscopy readout. This work is part of an effort to identify and characterize host genes involved in virus infection.)

2. Have you already submitted (or do you plan to submit) a screening application?

6. Please provide the title and registration number for the protocol approved by your institutional biosafety committee for the materials and work described above. Omission of this information will delay approval of your request.(For Harvard investigators, this should be your COMS registration title and number.)

7. Predicted approximate duration and frequency of work in the screening room.(e.g., Up to 2 hours per day, once a week for 3 months.)

A copy of your completed application will be sent automatically to the email address that you provided above.